The ratchet effect: dramatic and sustained changes in health care utilization following admission to hospital with chronic disease.

Med Care · 2014 · PMC4174034 · PMID 25054825

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may be significantno p-value reported

Furthermore, we have not examined changes in outpatient utilization, although such changes may be significant.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.